Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.01 / $86.02 / $106.66	Facility	26	$86.01	$86.02	$106.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.36 / $475.00 / $1,200.20	Professional		$234.36	$475.00	$1,200.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.55 / $111.15 / $464.10	Professional	26	$67.55	$111.15	$464.10
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $98.00 / $117.18 / $212.50	Professional	52	$98.00	$117.18	$212.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $125.17 / $281.41 / $454.31	Professional	TC	$125.17	$281.41	$454.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.40 / $188.94 / $298.79	Professional		$144.40	$188.94	$298.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.07 / $69.65 / $117.55	Professional	26	$52.07	$69.65	$117.55
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $91.21 / $167.50 / $197.06	Professional	TC	$91.21	$167.50	$197.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $176.64 / $460.00 / $759.36	Professional		$176.64	$460.00	$759.36
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.67 / $132.00 / $232.10	Professional	26	$65.67	$132.00	$232.10
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $110.09 / $328.00 / $533.11	Professional	TC	$110.09	$328.00	$533.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $222.09 / $487.35 / $823.00	Professional		$222.09	$487.35	$823.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.73 / $99.00 / $181.06	Professional	26	$67.73	$99.00	$181.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $146.07 / $314.70 / $668.89	Professional	TC	$146.07	$314.70	$668.89
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $106.80 / $144.00 / $235.00	Facility	26	$106.80	$144.00	$235.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $187.72 / $187.72 / $721.28	Professional		$187.72	$187.72	$721.28
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $260.64 / $260.64 / $260.64	Professional	26	$260.64	$260.64	$260.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.54 / $130.32 / $212.63	Professional		$63.54	$130.32	$212.63
United Facility/Professional Professional Modifier Low / Median / High Price $204.38 / $345.40 / $783.63	Professional		$204.38	$345.40	$783.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.37 / $91.38 / $151.88	Professional	26	$67.37	$91.38	$151.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.96 / $209.97 / $640.19	Professional	TC	$134.96	$209.97	$640.19